I really love my job.
God has allowed me over the course of my education, training, and work starting way back in 1992 to experience so many wonderful patients. I’ve been privileged to be present with so many dear people during their time of deepest need. It is hard to express just how much I value that time with my patients.
The crucial aspect to good patient care is having time. Time to be with my patients. Time to talk with and listen to my patients. Time to care for my patients. Time in the moment but also time across the days, weeks, and months of our professional relationship.
Much of medical school education and training is not restricted by time. What I mean is that much of our on the job training takes place without a detailed minute to minute schedule. For instance, very early during medical school hospital rotations I asked my senior resident what time I need to come in the next day. He said, “Early enough to get the job done.” Over the years that translated to 5am give or take depending on the rotation and the level of training.
Medical school and residency training requirements have changed in the last decade. Not to sound too much like an old fogey, but, back when I was an intern my work schedule was as follows: work 5am-ish to 6pm-ish two days in a row then work 5am-ish to 6pm-ish THE NEXT DAY. Our call days required we work roughly 36 hours straight every 3rd or 4th day. As much as it was exhausting, I loved it. I loved being in the hospital and at the bedside of my patients. Admitting a patient to the hospital then being present for all the acute treatments and seeing the remarkable improvement, if we were doing it right, was exciting.
In private practice, the third party payer system as we have in the United States prioritizes time as money. The more time you spend with a patient the less you make. It was a hard realization that occurred a few years into practice. Going from an environment where the more time you spent with a patient, the better doctor you were, to a setting where you were penalized for not moving on.
Mind you, I NEVER felt that way from my practice or my partners. In fact, in their wisdom they built into the very framework of Trinity a slower, more deliberate pace. We are known within our community as one of the lower volume, slower practices. My partners instituted hedges against being driven by finances at the expense of patients. Even as it felt the entire medical economic universe pushed and penalized us for not getting on board, they persisted in pointing Trinity always toward patient care first.
As the pressures grew over time, I knew we needed to explore a better way. This is why Direct Primary Care appealed so much to me. It allows me to spend the time I need with my patient. Sometimes I have the chance to spend a couple hours with a new diabetic and other times it allows for me to talk on the phone when a patient unexpectedly calls. I’m free to give my time away to my patients as needed. In fact, I’m back in a system that thinks the more time a doctor spends with their patient the better doctor they are.
Just this last week I had a mom call and request a same day appointment for her young child. As it is always a joy to see their family, I looked forward to the visit. When they came in the kids were as energetic as ever and immediately started to explain why they had come to the doctor. As they got checked in, the mom asked if the other child and herself could also be seen at the same time.
In my old practice model, that was an impossibility. I could realistically never squeeze in another two patients before my next one showed up. In DPC though, these were the last patients of my day. I had plenty of time to sit and talk about each individual’s concerns and work out a good plan. Even after all the chaos that two little children stir up late in the afternoon, they left satisfied with the plan and I was thrilled to have provided them the help they needed. Even if we hadn’t had the extra time that day, even if we had had other patients scheduled that afternoon, I still could have easily spent time on the phone or followed up the next day with another appointment. Since there is no per visit cost in our DPC program they could come back as often as is needed to help solve their problem.
Trinity Direct Primary Care allows me to keep the focus on my patients. I’m honored to be piloting this program for my group; perhaps to even be building a better model of healthcare delivery for all of Knoxville. I feel like I really do have time to care again.
If you’re interested in hearing what Trinity DPC can do for you and your health situation, give us a call at 244-1800 or connect with us at one of our Open Houses, schedule a Meet and Greet, or Medical Consult.